ACC Research Agenda Conference 2018: Peer Reviewer Acknowledgments and Abstracts of Proceedings
2017; Volume: 32; Issue: 1 Linguagem: Inglês
10.7899/jce-17-28
ISSN2374-250X
Autores Tópico(s)Evaluation and Performance Assessment
ResumoThe conference organizers wish to thank the many reviewers for their wonderful and necessary service. Their work makes the program successful and we are quite grateful. Medhat Alattar, Robert Appleyard, Christopher Arick, Iben Axen, Samir Ayad, Barclay Bakkum, Angela Ballew, Deborah Barr, Jason Bartlett, Patrick Battaglia, Edward Bednarz, Judy Bhatti, Charles Blum, Karen Bobak, Ron Boesch, Breanne Bovee, Linda Bowers, James Boysen, Rick Branson, Teresa Brennan, Joseph Brimhall, Thomas Brodar, Leo Bronston, Myron Brown, Thomas Brozovich, Paul Bruno, Jeanmarie Burke, Kara Burnham, Andre Bussieres, Alana Callender, Jerrilyn Cambron, Marni Capes, Beth Carleo, Jonathan Carlos, Cynthia Chapman, Michael Ciolfi, Jesse Coats, Richard Cole, Alena Coleman, Christopher Colloca, Stephan Cooper, Elaine Cooperstein, Robert Cooperstein, Matthew Cote, Brian Cunningham, Stuart Currie, Vincent DeBono, James Demetrious, MartinDescarreaux, Renee DeVries, Scott Donaldson, Paul Dougherty, Erin Ducat, Stephen Duray, Jonathan Emlet, Roger Engel, Melissa Engelson, Dennis Enix, Ana Facchinato, Mary Frost, Ricardo Fujikawa, Matthew Funk, Karen Gana, Charles Gay, Ronald Gefaller, Gene Giggleman, Craig Gillam, Brian Gleberzon, Jordan Gliedt, Christopher Good, Kenice Grand, Stephen Grande, Julie-Marthe Grenier, Thomas Grieve, Jaroslaw Grod, Tim Gross, Joseph Guagliardo, Maruti Ram Gudavalli, Tim Guest, Mitchell Haas, Michael Hall, Marcy Halterman-Cox, Michael Haneline, Daniel Haun, Navine Haworth, Xiaohua He, Kathryn Hoiriis, Aimee Hollander, Dana Hollandsworth, Todd Hubbard, Kelley Humphries, Adrian Hunnisett, Thomas Hyde, Jennifer Illes, Theodore Johnson, Aimee Jokerst, Gena Kadar, Martha Kaeser, Norman Kettner, Yasmeen Khan, Stuart Kinsinger, Anupama Kizhakkeveettil, Carolina Kolberg, Charmaine Korporaal, Thomas Kosloff, Danik Lafond, William Lauretti, Alexander Lee, Brent Leininger, Jonathan Leusden, Makani Lew, Kathleen Linaker, Tracey Littrell, Dana Madigan, Chris Major, Katherine Manley-Buser, Barbara Mansholt, Marc McRae, R. Douglas Metz, Thomas Milus, Silvano Mior, Veronica Mittak, John Mosby, Stephanie Mussmann, Jason Napuli, Harrison Ndetan, Shawn Neff, Lia Nightingale, David Odiorne, Casey Okamoto, Michael Oppelt, Tolulope Oyelowo, Kimberly Paddock-O'Reilly, Per Palmgren, Rachael Pandzik, David Paris, Steven Passmore, Georgina Pearson, Stephen Perle, Kristina Petrocco-Napuli, Mark Pfefer, Jean-Philippe Pialasse, Lynn Pownall, Mario Pribicevic, Mohsen Radpasand, Dewan Raja, Thomas Redenbaugh, Paula Robinson, Christopher Roecker, Anthony Rosner, Robert Rowell, Lisa Rubin, Drew Rubin, Robb Russell, Michael Sackett, Stacie Salsbury, Thiana Schmidt dos Santos, Michael Schneider, Gary Schultz, David Segal, Zacariah Shannon, William Sherwood, Peter Shipka, Brian Snyder, Brynne Stainsby, Joel Stevans, Gerald Stevens, John Stites, Richard Strunk, Kent Stuber, Stephanie Sullivan, Randy Swenson, Dorrie Talmage, Janet Tapper, Vinicius, Tieppo Francio, Steven Torgerud, Peter Tuchin, Elissa Twist, Joseph Unger, Michael VanNatta, Darcy Vavrek, RobertVining, Sivarama Vinjamury, Robert Walker, Paul Wanlass, Robert Ward, Keith Wells, James Whedon, Barry Wiese, Jon Wilson, Jessica Wong, Arnold Wong, H Charles Woodfield, III, Shari Wynd, Ting Xia, Kenneth Young, Niu Zhang.Jacques Abboud, Catherine Pauze-Brodeur, Arianne Lessard, Martin DescaurreauxObjective: To evaluate the effectiveness of an exercise protocol designed to induce delayed-onset muscle soreness (DOMS) in paraspinal muscles. Methods: Fourteen healthy participants were asked to perform four series of 25 trunk flexion-extension in a prone position (45-degrees inclined Roman chair). The protocol was performed using loads corresponding to 10% of the participant's trunk extension maximal voluntary contraction (MVC). Perceived soreness and pain were assessed using a 10-points visual analogue scale 3 times a day during 5 days post-DOMS protocol. Pressure pain thresholds (PPT) in paraspinal muscles (L2 and L4 bilaterally) and the vastus medialis (control site), and trunk extension MVC were assessed 24 to 36 hours post-protocol and compared to baseline (t-tests). Results: Peaks of muscle soreness (3.5/10) and pain (2.2/10) were observed 24 to 30 hours post-protocol. A significant reduction in trunk extension MVC was observed post-protocol (p=0.04). Significant reductions in PPT were observed post-protocol for all trunk extensor sites (ps<0.01), but not for the control site (p=0.52). Conclusion: The exercise protocol efficiently led to back muscle DOMS, reduced functional capacities and increased pain sensitivity. Such protocol could be used as an alternative to experimental low back pain in mechanistic studies. (This is a conference presentation abstract and not a full work that has been published.)Steve Agocs, Mark Pfefer, Dani Steffen, Nathan Hoover, Rachel Gilmor, Jackson BergObjective: Many orthopedic tests are commonly used by chiropractors during physical assessment to evaluate the neuromusculoskeletal system; however, the clinical accuracy of various tests is not always understood by providers. The aim of this study is to inform providers about clinical accuracy of commonly used orthopedic tests and highlight needs for future research. Methods: All unique orthopedic tests found in the Future Health Smart Cloud electronic health record (FHSC-EHR) were entered into a spreadsheet. A search of listed orthopedic tests was performed using MEDLINE and Index to Chiropractic Literature databases using keywords: named/listed orthopedic tests and/or reliability, specificity, and sensitivity. Included literature described clinical accuracy of all available orthopedic tests listed within the FHSC-EHR. Results: Eighty-six unique orthopedic tests were listed for use in the FHSC-EHR. Peer-reviewed, published information related to clinical accuracy was identified for 21 orthopedic tests, comprising 24.4% of total, unique orthopedic tests reviewed. Conclusion: The current shift toward evidence-based practice highlights the need to understand and use diagnostic tests appropriately. The limited amount of supporting data for many orthopedic tests demonstrates the need for additional research to improve clinical utility and accuracy when using orthopedic tests. (This is a conference presentation abstract and not a full work that has been published.)Joel Alcantara, Jeanne Ohm, Junjoe AlcantaraObjective: To characterize chiropractors and their patients under the paradigm of wellness care. Methods: In addition to socio-demographic information from our DC and patient responders, we inquired about practice characteristics (i.e., years in practice, reimbursement) and clinical correlates (i.e., clinical presentation, motivation for care), respectively. Results: A convenience sample of 206 chiropractors (150 females; average age=33.75 years; average years in practice =6.07 years) indicated their practice, on average, was 46.98% wellness with mean reimbursement as cash (58.17%) and insurance (40.97%,). The convenient sample of patients (N=2943; females=2011; average age=42.64) are highly educated with 87% having some college or higher. Fifty-nine percent indicated currently experiencing symptom care while 41% were asymptomatic. Current motivation for care were: to promote general health or wellness care (50%); to relieve symptoms (67%) and to improve their quality of life (57%). Fifty percent of the patients indicated paying with cash while 11% indicated paying wholly by insurance and 39% with cash and insurance. Thirty-seven percent indicated their medical doctor recommended wellness care. Eighty-two percent utilized exercise, 75% dieted and 64% used nutritional supplements as adjuncts to wellness care. Conclusion: Wellness care is predominantly cash reimbursed but not necessarily involve asymptomatic care. (This is a conference presentation abstract and not a full work that has been published.)Joel Alcantara, Jeanne Ohm, Junjoe AlcantaraObjective: To determine the interpersonal process of care (IPC) experience of parents with children under chiropractic care. Methods: We utilized the interpersonal process of care questionnaire (IPC-18) to measure communication, patient-centered decision-making, and interpersonal style experienced by parents with their child's chiropractor. Responses to the 18 items were on a Likert scale and linearly transformed (i.e., 1=never; rarely=2; sometime=3; usually=4; always=5) for analysis. Descriptive statistics (i.e., frequencies, means) was utilized with higher scores to the IPC-18 (range:1-5) indicating a better interpersonal experience. Results: A convenience sample of 138 parents (126 females; average age=36.49 years) participated in this study with similarly numbered children (75 females; average age=6.14 years) under chiropractic care. The average number of visits attended by the children was 26.07 (SD= 34.79). The mean scoring to the IPC-18 survey are the following: communication (i.e., lack of clarity (1.29±0.52), elicitation and concern of patient problems (4.87±0.31) and explanation of clinical findings (4.43±1.04)), decision making (i.e., decided together (4.48 ±0.88) and interpersonal style (i.e., compassionate and respectful caregiver (4.88±0.34), discriminated against (1.01±0.17) and disrespectful staff (1.03±0.14). Conclusion: Parents of children under chiropractic care experienced good interpersonal process of care with their child's chiropractor and office staff. (This is a conference presentation abstract and not a full work that has been published.)Joel Alcantara, Jeanne Ohm, Junjoe AlcantaraObjective: To determine the construct validity of the PROMIS global health items based on correlations with the PROMIS-29. Methods: In addition to socio-demographic information, the PROMIS-29 and PROMIS Global Health were implemented to measure domains of quality of life (QoL) and global physical health (GPH) and mental health (GMH) (respectively) to chiropractic patients. Statistical analysis utilized descriptive statistics and Pearson's r to determine linear correlation of the QoL domains. Results: Our convenience sample (N=148) comprised of 125 females and an average age of 35.5 years. PROMIS mean T scores were: physical functioning (56.01), anxiety (47.13), depression (43.56), fatigue (45.42), sleep disturbance (43.98), satisfaction with participation in social roles (56.13), pain interference (43.78), GPH (55.69) and GMH (56.60). The mean pain NRS score was 1.01/10. GPH correlated most strongly with fatigue (r = - 0.72), pain interference (r = - 0.50), and satisfaction with social role (r = 0.44) while GMH correlated most strongly with fatigue (r = - 0.51), anxiety (r = - 0.51) and depressive symptoms (r = - 0.50). Conclusion: There is support for the construct validity of the PROMIS Global Health relative to the PROMIS-29. (This is a conference presentation abstract and not a full work that has been published.)Joel Alcantara, Jeanne Ohm, Junjoe AlcantaraObjective: To determine the construct validity of the PROMIS-29 to the RAND SF-36.Methods: In addition to obtaining socio-demographic information, the PROMIS-29 and the RAND SF-36 were implemented to measure the quality of life (QoL) of patients presenting for chiropractic care. Statistical analysis utilized descriptive statistics (i.e., frequencies, means) and Pearson's r to determine linear correlation of the QoL domains. Results: Our convenience sample (N=2943) comprised of 2011 females and an average age=42.64 years. PROMIS mean T scores were: physical functioning (50.86), anxiety (50.67), depression (46.91), fatigue (49.97), sleep disturbance (49.06), satisfaction with participation in social roles (52.3), and pain interference (51.82). The mean pain NRS score was 3.006. The mean scores from the SF-36 domains were: physical function (82.26), role limitations due to physical health (70.58), role limitations due to emotional problems (72.16), fatigue (56.9), emotional wellbeing (76.94), Social functioning (82), pain (70.49) and general health (72.09). Conclusion: High correlations were found with physical functioning, fatigue and pain interference reflecting good construct validity of the PROMIS-29. (This is a conference presentation abstract and not a full work that has been published.)Brian Anderson, Steve McLellanObjective: To determine if members who present to chiropractors (DC) are at lower risk of utilizing advanced diagnostic and treatment methods for neck pain, as compared to those who present to primary care providers (PCP). Methods: Secondary analysis of medical claims in a self-insured workplace. We determined the prevalence of treatment escalation in each group. A previously developed treatment escalation model was modified and used in this project. Results: Between the years of 2012-2016, there were 2,218 DC members and 2,149 PCP members. Utilization of advanced diagnostic and treatment methods for all DC members over 5 years occurred as follows: Injections (124/5.6%); ER visits (69/3.1%); Imaging (387/17.4%); Surgery (100/4.5%). Utilization for PCP members occurred as follows: Injection (301/14%); ER visits (813/37.8%); Imaging (1955/90.9%); Surgery (207/9.6%). 6.1% of DC members escalated, while 30.4% of PCP members escalated. Conclusion: For every metric, the risk of escalation was significantly less in DC members vs PCP members. This discrepancy was most obvious when evaluating ER visits and imaging utilization. (This is a conference presentation abstract and not a full work that has been published.)Lauren Austin-McLellan, Anthony LisiObjective: Interprofessional collaboration has been known to improve health care processes. Interprofessional education is a known facilitator of interprofessional collaboration. Yet during chiropractic undergraduate training and continuing education, most chiropractors receive little exposure to or education about other healthcare providers. This foundational educational research project seeks to provide an overview of key medical and surgical specialties that may contribute to improved learning. Increasing chiropractors' knowledge about other healthcare providers, particularly medical physicians, can be a key factor for improving interprofessional collaboration. Data Sources and Selection: This was a synthesis of published data from the American Board of Medical Specialties and individual specialty boards, supplemented by qualitative input from subject matter experts. Data were entered into tabular format for review and analysis. Results: We propose the medical and surgical specialties most relevant to typical chiropractic practice are: primary care (internal medicine or family medicine), physiatry, pain medicine, rheumatology, neurology, radiology, orthopedic surgery and neurosurgery. Conclusion: A deeper understanding of the similarities and differences in the training and typical practices of these medical providers can enhance a chiropractor's competence to collaborate and increase participation in team-based care. (This is a conference presentation abstract and not a full work that has been published.)Lisa Barker, Barclay Bakkum, Cynthia ChapmanObjective: Monolaurin, known as glycerol monolaurate (GML), is a monoester of lauric acid and glycerol. It has been approved by the FDA as generally recognized as sage and is used in the food and drug and cosmetic industries. Monolaurin has been touted as a dietary immune system enhancer. The authors chose to investigate the antimicrobial properties of GML, it's safety and bioavailability, and the clinical indications for its usage. Data Sources and Selection: Pertinent articles were located with Pubmed searches. Reference sections of newer articles were searched for other relevant articles. 23 articles were located. Results and Conclusion: In vitro, GML is antimicrobial for several viruses and gram positive and negative strains of bacteria. This seems to be accomplished by permeating lipid membranes, retarding exotoxin production, and blocking signal transduction. GML also inhibits the mobility and motility of sperm and has anti-inflammatory and anti-erythematous properties. In the majority of studies, monolaurin was found to be safe. In vitro, GML was not found to be bioavailable due to low solubility and stability. No studies were found that supported the oral administration of GML on human subjects. Future research would ideally focus on this population and bioavailability. (This is a conference presentation abstract and not a full work that has been published.)Judy Bhatti, Elissa Twist, Josh Bernstein, Dustin Derby, Katherine Manley-BuserObjective: Presenters will describe academic stress and student confidence, and assess their effects within a sample of graduate chiropractic students. Methods: Demographic information was collected and the Academic Self-Efficacy sub-scale survey, a measure of student described stress of academic tasks, and student confidence in these activities was administered to year 1-3 students in a chiropractic college. Results One hundred seventy-three students from years 1 (n=47), 2 (n=70), and 3 (n=56) completed the survey; the population mean (SD) age was 25.7 (4.3) and 52.6% were men. Students reported their top stressors as [doing well in tough classes; Y1 and Y3], [having multiple tests in the same week; Y2]. They reported the lowest confidence with [doing well in tough classes; Y1] and [keeping up with required reading; Y2 and Y3].Conclusion Stress and confidence have an inverse relationship in many constructs, with some notable exceptions. There is high stress to do well in tough classes in all years, but students report more confidence as they progress through the years. Keeping up with required reading is low-stress for all three years, but students in 2nd and 3rd year have low confidence in this area. (This is a conference presentation abstract and not a full work that has been published.)Paul Bishop, Jeffrey Quon, John Street, Brian Arthur, Melissa Nadeau, Tamir Allon, Nicolas Dea, Charles Fisher, Marcel Dvorak, Scott Paquette, Brian Kwon, Gabriella PetrolinniObjective: To evaluate the feasibility of conducting a randomized controlled trial (RCT) of the effects of chiropractic spinal manipulative therapy (CSMT) on in vivo inflammatory cytokine (IC) expression and clinical outcomes in patients with acute sciatica and lumbosacral disc herniation (AS/LDH). Methods: Patients with AS/LDH of less than 16 weeks duration were randomized to 6 weeks of CSMT or the surgical wait list. Standardized neurological and lumbar spine examinations, VAS and Roland Morris Disability scores, and serum IC levels were assessed at baseline, 6, 12 and 24 weeks. ICs were also measured in disc tissue, nerve root and disc lavagate collected during surgery. Research ethics approval was obtained. Results: 40 of 44 (91%) invited patients participated and were randomized. 13 patients avoided surgery. Post-CSMT improvement was associated with longer duration of sciatica, absence of cross-over sign and motor deficit, reduced lumbar flexion increment and lower IC levels at baseline. Conclusions: It appears feasible to conduct a RCT with patients randomized to CSMT or a waitlist control group. There may be a sub-group of AS/LDH patients who will significantly benefit from HVLA CSMT. A large scale clinical trial is now required to test this preliminary finding. (This is a conference presentation abstract and not a full work that has been published.)Thomas Bloink, Charles Blum.Objective: A 57-year-old male presented to this office with extreme tongue fatigue and significant neck pain. Clinical Features: A month-prior the patient saw his general practitioner who prescribed antibiotics for possible throat infection and then 2-weeks later was seen by neurologist who diagnosed a cervical spine dysfunction and prescribed muscle relaxants, without any relief. Due to this condition lasting over a month, aside from coming to this office, he was referred to the UCSF neurology department to be assessed for amyotrophic lateral sclerosis (ALS). A few-years-prior he had extensive dental restorations, with bridgework, implants, and an over-the-counter bite-guard. Interventions/Outcome: Treatment consisted of sacro occipital technique category one (pelvic torsion reduced sacral nutation), left-temporal internal rotation, sphenomaxillary craniopathy, and TMJ care for significant malocclusion - co-treated with dentist to develop/fabricate a lower dental splint. The patient was treated for 9-office visits for two-months and received the dental care (1-visit per week for 3-weeks) in the first-month. At 2-months the patient's symptoms had completely resolved and ALS was ruled out. Conclusion: Further research is needed to determine if this type of chiropractic care might be helpful for similar types of presentations, working closely with neurologists and dentists. (This is a conference presentation abstract and not a full work that has been published.)Charles BlumObjective: A 27-year-old male rock/boulder climber presented for chiropractic care due to weakness and discomfort upon shoulder loading, particularly when rock-climbing. Clinical Features: This was a gradual onset chronic type injury, taking place over 6-9 months of elite indoor and outdoor rock climbing. Rock-climbing typically causes overuse syndromes affecting the myofascia of the anterior shoulders and cervicothoracic regions leading to forward head posture presentations and secondary cervicobrachial type syndromes. Intervention/Outcome: Treatment essentially consisted of sacro occipital technique (SOT) and extremity techniques to reduce the anterior/posterior fascial line tensions to minimize the forward head posture presentation on any thoracic outlet syndrome, re-position the humeral head in a posterior/anterior position and stabilize with, kinesiotape, and exercises to stretch the anterior shoulder girdle and strengthen the posterior scapula stabilizers. Following the initial office-visit the patient reported improved strength and could sleep without pain or stressed shoulder positions. The patient was treated in this manner two-times a week for two-weeks, and then once-a-week for two-weeks at which time he was able to return to rock-climbing. Conclusion: This case study presents a patient with gradual onset, chronic shoulder weakness and pain secondary to rock climbing successfully treated with a conservative method of chiropractic care. (This is a conference presentation abstract and not a full work that has been published.)Lori Beth Bryson, Jonathan Bryson, Brent Russell, Ronald HosekObjectives: Most backpack models commonly used by students are frameless packs (FLP), have no structural support, and are carried on the shoulders. Internal frame packs (IFP) are ergonomically designed to shift 90% of the load to the pelvis. Until recently, recording spinal data while wearing a backpack was difficult. We developed an IRB-approved protocol using inertial measurement units (IMUs) to quantify postural differences between the styles. Methods: Ten university students outfitted with IMUs walked on a treadmill under 3 conditions: no pack, pack loaded with 15 pounds, and after 15 minutes loaded walking. Participants wore an FLP the first day and an IFP the second. Results: With the FLP, most individuals moved progressively through the 3 conditions toward lumbar flexion and thoracic extension. For the cervical region, some reacted with extension and others with flexion. Spinal motions, and head and pelvic pitch, showed progressive increases in step-to-step variability with the FLP. Participants showed little change with the IFP. Conclusion: Outcomes from this study document sagittal postural adaptations to the FLP and suggest step-to-step inconsistency when compared to the IFP. We will expand this study to include additional participants and analysis of transverse and frontal planes. (This is a conference presentation abstract and not a full work that has been published.)Kelly Buettner-Schmidt, Donald Miller, Brody Maack, Mary Larson, Megan Orr, Becky McDaniel, Katelyn MillsObjective: Conduct a pilot study improving public health through intervention development implementing sustainable health systems changes based upon the U.S. Public Health Service: Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Methods: We used an adaptive feasibility method and recruited practitioners outside of large healthcare systems. Prior to intervention development, a chiropractic advisory board was organized and practitioner assessments were completed. The intervention included educational sessions, patient materials, standard patient scenario, and onsite academic detailing. Pre- and post-intervention measures included educational effectiveness and three levels of outcomes: systems/clinics, provider, and patient. Study approved by university IRB. Results: Post-intervention, all clinics had systems present to Ask-Advise-Refer users and the majority of clinics: met the health systems change definition for new episode-of-care patients; had systems asking about secondhand smoke exposure and e-cigarettes; and changed to office environments to include cessation materials. Chiropractors reported increased confidence to counsel patients, including referral. The majority of patient respondents at 30-day and 3-month follow-ups either quit or had attempted to quit since their appointment. Conclusion: While a 6-month intervention is a short time for systems change, the study resulted health systems change and chiropractors expressed enthusiasm for ongoing collaboration. (This is a conference presentation abstract and not a full work that has been published.)Kara Burnham, James MascenikObjective: Student satisfaction and performance are of primary concern when classroom pedagogy is changed. The intent of this study was to determine the equivalence of two teaching methodologies in a clinical microbiology course using test scores as the measure of student performance. Methods: The two teaching methodologies examined were a traditional lecture-based face-to-face (F2F) method and an inverted classroom method (ICM). Using a course survey, satisfaction with the ICM method was obtained by asking students to compare the ICM class experience with their experiences in traditional F2F classes. Classroom exams were administered in the same way in both pedagogies. The student test averages obtained were compared for equivalence using regression analysis. Results: Test performance of students in the ICM was equivalent to that of students receiving traditional F2F lectures. The mean difference between test scores for the ICM and the traditional F2F groups was 1.9 (95% CI= -4.0 to 0.14). Survey responses indicate that respondents feel positively about self-learning in ICM and prefer the flexibility provided by ICM. Conclusion: This study provides evidence that the ICM method of teaching clinical microbiology can replace the traditional F2F method without loss of student performance. (This is a conference presentation abstract and not a full work that has been published.)Andre Bussieres, Gregory Stewart, Fadi Al Zoubi, Philip Decina, Martin Descarreaux, Danielle Haskett, Cesar Hincapie, Isabelle Page, Steven Passmore, John Srbely, Maja Stupar, Joel Weisberg, Joseph OrnelasObjective: To develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. This guideline addresses the use of spinal manipulative therapy (SMT). Methods: Topics were chosen based on an AHRQ comparative effectiveness review on SMT and non-pharmacological interventions. We updated searches in MEDLINE and Cochrane database, and assessed the quality of admissible randomized controlled trials and systematic reviews. We used GRADE to summarize judgments of the evidence quality and link recommendations to the supporting evidence. The panel determined the certainty of evidence and strength of recommendations. An 8-member external committee reviewed the guideline. Results: For acute LBP, we suggest: SMT, other commonly used interventions or a combination of SMT and commonly used interventions in addition to advice (posture, staying active), reassurance, education and self-management strategies to improve pain and disability. For chronic LBP, we suggest: SMT over minimal intervention or SMT as part of a multimodal therapy (exercise, advice and education, soft tissue therapy). For patients with chronic back related leg pain, we suggest SMT with home exercise and advice. Conclusion: A multimodal approach is an effective treatment strategy for back pain, with or without leg pain. (This is a conference presentation abstract and not a full work that has been published.)Alice Cade, Kelly Jones, Kelly Holt, Abdul Moiz Penkar, Heidi HaavikObjective: To assess the feasibility of studying the effects of chiropractic care on oculomotor control in children with ADHD. The secondary aim was to assess preliminary efficacy of chiropractic care on oculomotor control in children with ADHD. Methods: 30 children (8-15 years) participated in a randomized controlled crossover pilot study. Feasibility assessed recruitment, randomization, retention, eligibility, data collection, equipment and intervention tolerability. Oculomotor function was tested pre/post chiropractic/control intervention measuring target acquisition, reading speed, fixation time, and saccade length. Results: Recruitment was timely, 27 participants completed the study and retention rate was 100%. 30.4% completed the post-study questionnaire with 85.7-100% agreeing/strongly agreeing with positive study statements regarding the study. Efficacy findings revealed significant reduction (p=0.03) in total reading time post-chiropractic (mean reduction: 646ms (SD = 1508.91ms)) when compared to post-control intervention (mean reduction: 108ms (SD = 1971.01ms)). Post-hoc analyses su
Referência(s)